What's the harm in naturopathic medicine?

Dr. Carla Holinaty is one of 43 doctors across Canada who asked the Alberta College of Naturopaths to investigate the naturopath involved in treating a boy who died of meningitis. (GordWaldner/Saskatoon StarPhoenix) Gord Waldner / The StarPhoenix

Saskatoon family physician Dr. Carla Holinaty was one of 43 Canadian doctors who felt they had to speak up after the death of Ezekiel Stephan.

The toddler died of meningitis in 2012 after his parents attempted to treat him with non-medical, natural therapies. The office of Lethbridge naturopath Tracey Tannis sold Ezekiel’s mother an Echinacea tincture hours before the boy was taken to hospital near death, though it’s unclear if Tannis actually met the family.

Holinaty’s group wrote to the College of Naturopathic Doctors of Alberta after Ezekiel’s parents stood trial this spring, asking it to investigate Tannis’s role.

“We decided it was enough of a concern that we couldn’t just sit idly by and do nothing and decided we needed to take some sort of action,” Holinaty said. The college subsequently said it would conduct an investigation.

Naturopathic medicine is gaining popularity in Saskatchewan, and last year the provincial government introduced updated and expanded legislation to govern it.

The number of naturopaths registered with the provincial association grew by 27.5 per cent in 2013, and by another 10 per cent in 2014, to a total of 44 members, according to the Saskatchewan Association of Naturopathic Practitioners’ 2013 and 2014 annual reports.

The association itself declined to comment.

The Canadian Association of Naturopathic Doctors did not respond to a request for comment.

Homoeopathy, the formation of elixirs made from tiny concentrations of natural substances, is one of the more controversial aspects of naturopathic care. It’s based on the idea that “a substance that may cause certain symptoms in a healthy person can also cure similar symptoms in an unhealthy person,” according to the website of True Potential Health Services, a Saskatoon clinic.

Other services advertised by Saskatoon naturopaths include acupuncture, detoxification, nutrition, and cancer prevention. Saskatoon naturopaths claim to be able to treat a broad range of conditions, from acne to Hepatitis, the common cold or Multiple Sclerosis.

Holinaty said patients are asking their family doctors about naturopathic medicine almost daily.

“It’s become such a part of mainstream health culture that it’s out there all the time.”

She’s not against a patient investigating a natural remedy for a minor illness like a sore throat, but in an urgent case would discourage that in favour of immediate intervention, she said.

“I think there’s a lot going on there,” Timothy Caulfield, the Canada Research Chair in Health Law and Policy, said of the growing trend.

Partly, some people feel something is missing in the conventional patient experience, he said.

“As part of my research I even went to a naturopath, and it was a very positive experience. The person spent time with me, they seemed to really be interested in my problem, they seemed to really be listening to me and they spent a lot of time with me.

“And that’s not an experience most people get when they go to see their doctor. They feel rushed, perhaps not listened to.”

He also senses a growing distrust of traditional health care, including Big Pharma and its influence on evidence and what’s provided in the conventional setting.

Meanwhile, people are gravitating to the idea that natural cures are better, he said. Alternative practitioners have marketed themselves as more focused on prevention and a holistic approach, which he calls a “complete straw man argument,” since conventional practitioners are also supposed to be focusing on prevention.

While he’s sympathetic to government efforts to protect patient safety, formal regulation legitimizes unproven therapies based on a spiritual idea, he said.

“If it was a science-based profession they wouldn’t provide homoeopathy, they wouldn’t provide detoxes, they wouldn’t do iridology, they wouldn’t do IV vitamin infusions, you just go down the list.”

While an ineffective remedy might not cause physical harm it could be considered to cause financial harm, he said.

Six years ago, Kirby Criddle took a homeopathic pain remedy from a naturopath when she had her wisdom teeth taken out. The three-plant mixture prevented any swelling and pain, and she didn’t take a single pharmaceutical drug, she said.

Until then she had been skeptical of the practice, said Criddle, who now runs her own wellness clinic, offering reiki, meditation, nutrition and herbal medicine services.

“After that, I was like, ‘I’m sold, this is amazing.’ ”

Lucy Ormerod, a naturopath in Prince Albert since 2003, also used to be a skeptic.

However, when pharmaceutical drugs to treat grand mal seizures made the triathlete feel “comatose,” she turned to homeopathy and hasn’t had a seizure in 16 years, she said.

She had to jump from biochemistry — she spent seven years studying science in university — to what she calls the “quantum physics level of healing.”

There’s “tons” of difference between naturopaths — some don’t believe in homoeopathy, for example, while others practise it exclusively, Ormerod said.

“I practise things like homoeopathy. People will say it’s unscientific, which is not true — we just have to look at science on the deeper level of quantum physics.”

She also practices Bowen therapy, which uses gentle touching to “reset” the nervous system. It has worked for people with muscular-skeletal, hormonal and neurological problems, she says.

Prince Albert naturopath Lucy Ormerod. Submitted photo

Naturopathic medicine has become more popular as the Internet allows people to understand “they’re not being told everything they need to be told,” particularly in regards to pharmaceuticals, she said.

“It’s not more popular just because it’s a fad — it’s because it works. My patients get better.”

Ormerod believes in a vital force which homoeopathy can bolster to help the body and patient work through the illness.

“We’re dealing with a non-molecular substance. We’re treating a state — we’re using a medicine that is non-material — that’s affecting, basically, on a quantum physics level.”

Caulfield calls that explanation of homoeopathy “absolutely ridiculous” and “a last-ditch effort to make it sound science-y.”

Ormerod said she encourages patients to ask hard questions.

“I don’t try to convince people. I’ll tell them what I can offer them and I’ll give them information to read, but I’m certainly not interested in trying to persuade someone to do something.”

Ormerod said she wasn’t aware of the Ezekiel Stephan case. She declined to comment on it.

However, she said when it comes to criticisms of naturopaths, “they’re always trying to burn us at the stake. One thing goes wrong and it’s a big thing. But something goes wrong medically — it happens all the time — it’s all swept under the table.”

Dr. Louise Gagne of Saskatoon is part of a movement aiming to bridge the gap between conventional and naturopathic medicine. She practises and teaches integrative medicine, an approach that incorporates nutrition, supplements and mind-body medicine into conventional medical practice.

“Ideally you don’t want your advice about natural health products to come from the sellers of those products. You’d like it to come from an independent person who has some medical training,” she said.

A family physician should be able to tell a patient whether to take a multivitamin and if so, which one — but she couldn’t have answered those questions when she graduated, she said.

“I could resuscitate someone if their heart stopped beating, but I didn’t know whether they should take a multivitamin or not.”

While she won’t do muscle testing for food sensitivities, she might work with an asthma patient to improve lung function through dietary changes, in addition to an inhaler. Other patients are eager to minimize their prescription medication, she said.

In response to an interview request, a provincial health ministry spokesman said Health Minister Dustin Duncan was not available.

Duane Mombourquette, executive director of partnerships and workforce planning for the ministry, said the new legislation’s main objective is to create a self-regulating naturopath college. It means no one can legally pretend to be a naturopath, and it gives the college clear authority to conduct investigations, discipline members and set rules around standards of care, he said.

In response to Caulfield’s concerns, he said regulation of naturopaths isn’t new — the old legislation dates back to 1954.

“What we’re doing is strengthening the powers of the college. This is not something that’s unique to Saskatchewan. There are other provinces where naturopathic medicine is not only practised but it’s fully regulated as well.”

Before the act is formally proclaimed into law, the budding college must develop bylaws around the practice of naturopathic medicine.

At its March meeting, the College of Physicians and Surgeons of Saskatchewan council declined a request from the province’s naturopaths to establish a list of medications that naturopaths should be permitted to prescribe.

“It is extremely difficult when you are functioning on a particular theory as to what causes disease and what is likely to cure disease, to try to put yourself into the mind of somebody else with very different training and very different theories about what is appropriate treatment,” associate registrar Bryan Salte said.

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